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Thursday, July 7, 2016

Why Psychiatric Labels Are More Deadly Than Guns

Make no mistake about it. Psychiatric labeling is a weapon. The effects are drastic and dire. In practical effect, it occasions the social, financial and often physical death of those so labeled. Yet, far from wielding their power responsibly, the healthcare professions are replete with self-dealing and self-interest. (1) In the current state of the science, the ethical obligation of do no harm is a factual literal sham. In these circumstances, professional license to label fellow citizens - a life and death sentence for many - can and should be revoked.

Don't think the labels are deadly? Consider these facts:

Literally millions of Americans are being diagnosed and labeled by licensed mental health professionals every year. The threat presented by firearms pales in comparison. Yet, industry lobby, pharmaceutical PR and public prejudice have succeeded in keeping this issue under the radar.

Every day, you hear friends, neighbors and politicians sighing about about how easy it is to get a gun. Yet, practically no one blinks an eye at how easy it is to get a psychiatric label. Under the new DSM, virtually every uncomfortable experience known to humankind now qualifies for a psychiatric label. (2) Even more disturbing, there are actual government and industry campaigns to make people more open seeking and accepting the labels mental health professionals dole out. (2.1) Promoted as a prevention tool, schools and primary care providers are routinely screening and steering unsuspecting candidates into the industry pipelines where mental health label are routinely assigned.

Yes, I know the official party line is that we need more mental health labeling and less shame and resistance. But that is exactly why the average American family -- and the public at large -- needs to be protected. In reality, we've been sold a bill of goods by the very groups that are supposed to be protecting us (professionals, hospitals, researchers and public health officials).

The health risk this is creating is far more dangerous than firearms for the average American. Here's the down and dirty:

1. The label serves your doctor not you.

Make no mistake about it. You are not getting a label for your own benefit. The label says nothing about what caused your distress. You don't get to tell your doctor in your own words what's troubling you. The label doesn't buy you help for the issues in your life that you want fixed. To the contrary, a label does two things:

It gets your doctor a list of physical symptoms that can then be connected with a list of medications that drug companies say their products lessen.

Unless your doctor is exceptionally caring or enlightened, that's it. That is the standard of care in psychiatry today.

2. The labels are unnecessary

For talk therapy - where you might actually be identifying and working on the real sources of your distress -- the label is totally unnecessary. It's sole purpose is to wink wink nod nod, pull the wool over the eyes of insurance companies and convince them your problem is really 'medical.' As a practical matter, most people and many therapists don't believe this. Moreover, the work they do together doesn't reflect this. If the system were honest - and providers and clients were allowed to be honest - the labels would actually meaningfully describe the real-life problems and issues that are being addressed, e.g.:

Overwhelmed by life responsibilities

Feeling lonely, empty or disconnected from self or others

Life takes too much energy, gives you too little back

Relationships are challenging and hard to make work

Worries about finances, bills, work, keeping a job or a roof over your head

Stress of being a good parent, partner, family member or friend

Difficult losses

Hard choices to make

Coping with physical health concerns

Unsafe environment, relationships, world we live in

Discrimination, bullying, being targeted, singled out, actively abused at home, work, school, in the neighborhood or community, by caregivers, relatives, neighbors, or community members

Flashbacks to earlier trauma

Getting criticized or marginalized for being honest or speaking your truth

Spiritual / existential questions (meaning of life, fear of death or loss)

If we were serious about wanting people to use mental health services - and serious about wanting to reduce the shame, stigma and discrimination associated with mental health service usage - we would let people seek and receive publicly-funded healthcare services for reasons like those above. Moreover, normal life concerns like these would be considered a legitimate basis for billing private insurance as well.

The fact is life is difficult and challenging. You don't have need a medical reason to be distressed. Moreover, people can and should be able to access the support of other human beings when we need it the most. In difficult times, we all deserve access to others with the experience and wisdom to help us navigate life challenges in principled, meaningful ways. Letting people use mental health services for these natural, normal real-life concerns - and letting providers bill for these kinds of services - would vastly reduce the shame, stigma and damage associated with mental health service usage.

3. The labels cause actual physical and social injuries

Psychiatric labeling is literally a death sentence for many of us. Serious labels - like major depression, bipolar, schizophrenia - take on average (on average!) 25 years off our lives. And just so you know: That's not for the 'bad patients' who ignore medical advice, it's for the good one's who actually follow it. (4), (4.1) The actual life consequences that follow from the fact of psychiatric labeling -- disconnection with one's former life, disconnection from family, employment, community esteem and other protective factors, exposure to toxic chemicals and damaging procedures in the name of treatment, efforts to deal with the demoralization that accompanies loss of meaningful social roles - all converge with devastating impact. (5) You are barely reaching the prime of your life, but we are already dead. That's the difference a psychiatric label makes for us.

4. Private citizens should not have this kind of power

Where in our society can a private citizen exercise this kind of power? Aside from the mental health profession, where can one private citizen just go ahead and take 25 years off another's life -- just like that...? What gives any private citizen, no matter how educated, no matter what kind of credentials, the right to that kind of power over the fate of another...?

We live in a country where all of us - every last one - is supposed to be guaranteed a right to life liberty, property and due process of law. We are supposed to be protected - and we are supposed to be protecting each other - from this kind of arbitrary interference. But in the mental health system, the exact opposite is the case. All it takes here, to throw someone's life under a bus is the judgment of single clinician who has been given the power to label and is not afraid to use it.

And, once the label starts the ball rolling, the popular social bias pretty much makes sure that you reach the bottom of the hill.

Innocent people lose their jobs, get discriminated against, get shunned by friends and neighbors as a direct result of mental health labeling. People get told they have no future and denied important life opportunities as a direct result of mental health labeling. People get removed from their lives, denied the right to make basic decisions about their own welfare, relationships and belongings. They get denied access to their families, children, property, work. They get locked up, locked in, drugged, shocked, secluded and restrained for minor differences of opinion. No one acknowledges their preferences or recognizes their choices as having meaning or validity. They get charged enormous amounts of money for this in the name of 'treatment.' They are sent home to lives in ruin, facing enormous bills, relationships have disintegrated, pets have died, employers have moved on, homes and apartments have been lost. There are no resources and few options to rebuild with.

When people respond badly to these kinds of set backs, mental health professionals take the further step of labeling them chronic or 'treatment resistant.' This paves the way for even more invasive procedures like heavy duty neuroleptics, electro-shock, electrode implants and psycho-surgery.

When people legitimately become frustrated, demoralized or outraged by professional 'help' that doesn't help, and professional 'services' that don't actually serve their needs, they are routinely labeled a danger to self or others. In the proceedings that follow, they are legally stripped of personhood and then forced into progressively invasive monitoring to ensure 'compliance' with the very procedures that didn't work (and often caused actual injuries) in the first place . In other words, instead of looking at itself, and doing an honest self-assessment, the mental health profession blames, coerces and progressively debilitates the very people who come to it for help.

Arguably, this kind of treatment should not happen to any human being, ever, for any reason. In the United States, at the very least, you are supposed to have been convicted of a crime, in a court of law, before a jury of one's peers, knowing the charges against you, with a right to confront your accusers, cross-examine them, and have a lawyer appointed who helps you to prepare for your defense.

In the mental health system, if you remain silent they use it against you. If you deny the charges, they use it against you. If you disagree with the experts, they use it against you. There is literally no way for one private citizen to get rid of the label that another private citizen with the privilege to label has assigned. This must stop. (5.1)

5. The treatment on average is worse than the dis-ease

Your kid goes in sad and come out suicidal. Your spouse goes in anxious, and the next thing you know they are punching holes in walls. You start out with garden variety anxiety and end up a benzo addict. Psychiatry says these are exceptions or the result of 'illness.' But for many, many people, this kind of wreckage has become the rule of our lives.

The fact is, psychiatry is distributing mind altering chemicals, with highly individual effects. We don't know how people will react before they take them. For a lot of people, it gets worse not better. For some or us, the results are down right tragic. As a personally devastating case in point: Under the effects of a drug I had never taken before, the beloved family dog went unnoticed in the car and didn't come out alive.

From a big picture standpoint, it might not be so bad if the drugs, on average, led to better long-term results. But, sadly, they don't. (6), (7) So-called schizophrenics in Third world countries (who can't afford pharmaceuticals) do far better than we do in the United States (where pharmaceuticals are pushed, pushed, pushed as essential from diagnosis until death.) (8)

For myself, I went in as a Justice Department lawyer with persistent, but manageable low mood. After a couple years on anti-depressants, I no longer had the same brain I started with. Innocently I tried to come off the drugs, giving myself a slow taper, and a self-funded sabbatical, just in case I needed some added cushion. To my horror, I was unable to think, focus or learn. I couldn't follow a conversation because I couldn't remember the words from the beginning of the sentence long enough to hear to the end of it.

That was just the beginning. Since that time, I've had depressive relapse after relapse. Not the annoying "I feel really bummed about life" kind that I had for my first 35 years before starting SSRIs. (What I wouldn't give to have that back.) Nope, this was the 'praying to die' kind - more along the lines of I can't imagine how I'm ever going to function again, my brain isn't working anymore and I can't imagine going on like this.

Think I'm an isolated case? Check out the long-term studies. By far, your best shot at recovering from a mental health crisis is to avoid conventional medication-based treatments. Barring that, your best bet is to walk away from them as soon as you can. Painfully, sadly, tragically, far too many of us have come to live this truth: Over five, ten, twenty years, the recovery rates are remarkably better - and the disability rates remarkably lower - for non-compliant patients who reject their doctors advice and decide to go it on their own. (9)

Stated in plain English: In the mental health arena, patient non-compliance is an evidence based practice.

6. The so-called chemical imbalance theory is a fiction

You've heard this one right? Your brain chemistry is out of whack. You need medications like a diabetic needs insulin.

Yes, Frosty, you've been snowed. This was never more than a theory, popularized by a drug industry that wanted to sell pills. (10) The medical profession - which believes in pills - latched onto it. They used it, time and again (although they now claim they were just making 'an analogy') to convince us skeptics to follow their advice. (11)

Regrettably, a lot of did. We now have 'permanent' incapacity - not because of the brains we were born with, but because of the treatment itself was disabling.

From a public health standard point, trauma is the 'common cold' of our emotional existence. Indeed, research shows that 90 percent of public mental health clients are trauma survivors. (13)

But are your doctors asking you about trauma? Are mental health professionals screening for - and ruling out - obvious natural sources of human distress? Are they trying to distinguish between symptoms that stem from biological causes and those that stem from traumatic or other life stressors...?

In the vast majority of cases, no they are not. They are just going through check lists and ticking off symptoms as if what we feel, experience and manifest in our minds and bodies has no connection at all to what is happening in the rest of our lives.

It is like your primary care physician refusing to screen for and rule out the signs of the common cold before diagnosing you with lung cancer. In both cases, you'll probably have a cough and some congestion. In real medicine, however, it is malpractice to not check for and rule out lesser conditions (common colds) before proceeding to diagnose a more serious one (cancer). In psychiatry and mental health, however, ignoring or skipping over obvious natural causes is the actual, accepted standard of care.
This flies in the face of reason. What legitimate scientific profession would ignore a single common denominator - like trauma - that affects 90 percent of its presenting population? On the face of it, trauma is a far more plausible explanation for mental distress. The 'chemical imbalance' theory has still not borne fruit despite billions of dollars in research, and genetic theories aren't faring that much better. But instead, psychiatry is going the opposite direction. In their most recent diagnostic guidelines (the DSM V), psychiatrists actually eliminated the only part of their standard clinical assessment (Axis IV) that had formally looked at the contribution of psycho-social factors. (14)

8. We need honest inquiry and honest effort

The issue isn't that the connection between these normative life challenges and behavioral health can't be known. It can and, to some extent, already is. The correlations between adverse lived experiences and psychiatric diagnoses are remarkably high.

The issue also isn't that we couldn't be doing routine screenings for normative life challenges, and offering meaningful, effective, practical solutions to those who want them. We could, should and in certain limited ways already are. However, the promising outcomes of pragmatic, normative approaches like Housing First (14) and Self-Directed Care (15) are only the tip of the iceberg as to what could be achieved if the collective will for change were there.

The issue is that the interest and investment of the very people who are saying they are here to help us - the helping professions - is not there. Clinicians are neglecting these things not because there isn't a need or there isn't a way. They are neglecting these things because there is little awareness and almost no incentive or support to even try. Money spent researching and implementing pragmatic, normative approaches pales in comparison to what is spent on drug-based (Pharma-promoted) approaches. Even worse, money spent publicizing the availability of pragmatic, normative approaches is not even on the radar compared to the advertising the drug industry is able to fund. Added to that, jobs, livelihoods and organizational survival are all conditioned on complying with and replicating the existing disease model paradigm. Labeling exists, labeling persists, because that's what insurers (and including federal government) reimburse - and hey, you gotta make a living somehow. In practical effect, it amounts to an entire profession tacitly agreeing to stick its head in the sand and ignore its own ethical mandate of Do No Harm.

On the other hand, it doesn't have to be this way. If you sincerely wanted to demonstrate the efficacy of pragmatic, normative approaches - either standalone or as compared to drug-based interventions - you could easily do this. The experimental design is relatively simple. You ask people what they think is the problem and then you help them to fix it. You measure the extent to which the problem gets fixed from their perspective -- and the extent to which people feel and do better as a result. If there's a correlation (from experience, I'm pretty sure that there will be), then the pragmatic, normative approach is evidence-based. No labeling or pathologizing needed.

Then, if you want to make things really interesting, you compare the outcomes of the pragmatic approach to a control group that gets medical model treatment as usual - the kind where you ignore peoples' self reports in favor of symptom checklists, 5 minute med-checks and ready-made scrips. You see who does better, you see which approach is more cost-effective -- in both the short-run and the long-run. (From experience I'm guessing that, in an honest face off like this, the medical model doesn't stand a chance - especially if you follow the outcomes over any significant period of time.)

To my way of thinking, that would be meaningful a meaningful study. To my way of thinking, that would meaningfully contribute to what we know about public health. To my way of thinking, it's time we made this study happen.

It's time to revoke the right to label

Even in ideal circumstances, it is doubtful that anyone should hold the power to label another human being. The current state of the 'helping' professions removes any shadow of a doubt.

The way things stand, we have an irresponsible, unethical, bias-promoting industry doling out dangerous, damaging psychiatric labels as if they were candy. Far from being scientific or 'evidence-based', the practice is driven by little more than industry convention and billing concerns. The professional responsibility to conduct sincere and meaningful scientific inquiry - and to protect the people it claims to serve vis-a-vis self-interest and unscrupulous economic predators (e.g., Big Pharma) -- has been all but abandoned.

The practical impact on public health and safety are enormous. The mental health profession itself is killing far more people, reliably predictably, every year than guns. If this were any other social context - or if the 'mentally ill' were not the preferred American whipping boy de jure -- we would not be deferring or conferring to mere private citizens this blatantly arbitrary public power.

So, before you complain to me about out-of-control gun owners, I want to talk to you about an entire profession that is out of control, deadly and literally killing thousands of law-abiding American citizens every year. The reality is, the American people don't need more professionals or their help. More professional 'help' won't stop what's killing us the fastest. To stop what's killing us the fastest, we actually need protection from the current helping professions and the way they are doing their business.

For starters, let's take away their right to label. Let's force the science to be honest. It's the single most important thing you can do to protect your family's welfare and your own. It's the downright patriotic thing to do - whether or not you own a gun.

15 comments:

So True, every word! But there's no such thing as a 'Mental Health Professional'; NO SUCH THING! They are payrolled government psychiatry-budget racket parasites on an Australian feeding frenzy of $28 Billion! www.glennfloyd.org/oped.pdf

So True, every word! But there's no such thing as a 'Mental Health Professional'; NO SUCH THING! They are payrolled government psychiatry-budget racket parasites on an Australian feeding frenzy of $28 Billion! www.glennfloyd.org/oped.pdf

Excellent work! I agree 100%. I know these "screenings" seem to screen for drug company purposes and clearly screen in order to provide "help that isn't help." Looking back on my public school days, I think some screening did me good. Checking for head lice was done, and peeking into kids' mouths to check for redness, swelling, or any other obvious sign of potentially communicable disease. These could cause serious public health problems or poor school performance. I am grateful that someone finally figured out I needed glasses in second grade! Beyond that, I would have appreciated more school education about bullying and teasing. Kids should have more opportunity to talk to older students, teachers, or someone older whom they connect with if they are being teased, if things aren't okay at home, if their lunch money gets stolen, or if they are too hungry to pay attention in class. The object should be to stop the teasing and educate the teasee, instead of psychiatrizing and labeling the underdog child. Clearly, psych labeling is not the answer! It doesn't take rocket science to figure this out, either, yet our tendency to fall back on "experts" has blindfolded society into ignorance of these matters.

All of this is absolutely true. And I am looking for alternatives. We cannot beat big pharma or the psychiatric industry up front. We do not have access to the mainstream media, they are owned by advertisers such as, you guessed it, and while Open Dialogue and Soteria type programs are appearing there is a real fear that they will be subverted by the current power base. However I believe most primary care physicians are well intentioned, that they care about and want to help their patients, but are hamstrung by aggressive patients (who have seen the ads), time constraints, lack of training (the average medic has approx 40 hours training in psychological medicine and virtually none in normal psychology) and misinformation from the specialists he must trust. So we must educate. I propose a well organised program carried out by volunteers who are trained in the same way that drug reps are trained i.e. to sell their message. This is vital and MUST be tightly organised and controlled. The first sign of any radical element will destroy our credibilty immediately.These people would take the message directly to the GP’s office, using the same strategies. After all we are marketing our view. We can’t afford big lunches and conferences but we can organise small ones at community facilities, inviting local doctors, community and infant welfare nurses etc to Q & A sessions, perhaps with guest lecturers. We could visit playgroups, kindergartens (these kids are the next target for big pharma), schools and colleges, talking to the teachers as well as the students. The general idea is to quietly slip under the radar so that the message is out there BEFORE the big guys get wind of it. Once they do, there are all kinds of obstacles they can throw up including money. I believe sedition to be more effective, at least, at first, than confrontation. Machiavelli noted that though `conspiracies conducted by a handful of `men’ acting secretly invariably meet tragic ends, and open revolts involving large numbers of people do not...they may begin as secret conspiracies [until] the secret is shared’ ...It’s time to share the secret.

I like Deirdre's idea, Sarah. A lot. Plus I know this idea got knocked down in another forum but art, music, poetry, plays, all these are ways to reach people including children's literature. I sometimes do short comedy clips, illustrating the insanity of psychiatry. Matt Cohen did a talk in Boston and I went to it. It was so inspiring to hear something other than "stay on your meds and keep your appointments." Matt spoke of the inappropriateness and mismatching that happens, and lack of listening. But he also offered hope and I liked that. Young people are curious about what the world used to be like ages ago, so this can be an opportunity for those of us getting on in years as well.

Sarah, you said it! I'm not ashamed to say that I HATE psychiatry. It really is only a counterpart to the criminal justice system. Only a few differences exist between the psychiatric and penal systems: psychiatry's punishments are stiffer, psychiatry's inmates have usually committed no crimes, and due process of law is not afforded to the inmates of psychiatry at ANY stage of their involvement with this sick and unconstitutional racket. Psychiatry would have gone extinct by now if it weren't enforcing our Puritanical family values and employing so many people (I say "many" because, fortunately, all psychiatric clinicians aren't quacks. God knows I'd have lived a MUCH better life if I'd been cared for {not "cared" for} by a doctor like Kelly Brogan, M.D.) who can't do anything else to either earn or scam out a living. It's so refreshing to read the truth about psychiatry. Thanks goodness this article is being shared so widely.

Excellent article. My labels are, bipolar, pychso=effective, narcarsistic, and now I have PTSD. Life has fallen apart for me since I was diagnosed 18 years ago. There the ones with a mental illness, not us.

I am living proof of all that you shared, Sarah... I was born to subvert the dominant paradigm... the first time I was hospitalized, it was for rejecting my parent figures' fundamental religious life... while I never submitted to the mind-numbing medications, I bought into the notion there was 'something wrong with me,' then I did the math - all minus something equals lots of things right with me... instinctively, intuitively, I began to educate myself through my 'symptoms.' I began to appreciate that the behaviors I was exhibiting were reactions to the traumas inflicted on me - emotional neglect and physical and sexual abuse. I sought out ways to heal. In my late 40s, I found the peer community and began to heal. I used my lived experience to help others see things differently. I was also introduced to the work of Dr. Szasz who preached that psychiatry is merely a legal means for sequestering people whose behaviors made other people (society at large) uncomfortable. On the bright side, at least for me, doing this afforded me the opportunity to create a life of my own choosing. My self-esteem began to rise, a new self-image began to emerge. And I still subvert the dominant paradigm by educating the people that look to me for guidance. Thank you for writing this, Sarah